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What
is cholera?
Cholera
is an acute, diarrheal illness caused by infection of the
intestine with the bacteria Vibrio cholerae. The
infection is often mild or without symptoms, but sometimes
it can be severe.
Who
gets cholera?
Although
cholera is extremely rare in the United States, anyone can
get cholera if they drink water or eat food contaminated
with the cholera bacterium. In an outbreak situation, the
source of contamination is usually the feces (stool) of
an infected person. The disease can spread rapidly in areas
with inadequate treatment of sewage and drinking water.
Cholera
has been very rare in industrialized nations for the last
100 years; however, the disease is still common today in
other parts of the world, including the Indian subcontinent
and sub-Saharan Africa. Since 1991, epidemic cholera has
been a problem in South America. A few persons in the United
States have contracted cholera after eating raw or undercooked
shellfish from the Gulf of Mexico.
How
is cholera spread?
Cholera
is spread in contaminated water and food. Cases of cholera
that occur in the United States are usually among persons
who have traveled to places where cholera is common, or
among persons who have eaten contaminated food brought back
to the United States by other travelers.
The
disease is not likely to spread directly from one person
to another.
How
soon after exposure do symptoms appear?
Symptoms
can occur within hours up to five days after consumption
of contaminated food or water, usually in two or three days.
How
is cholera diagnosed?
Cholera
is diagnosed by isolating the cholera bacterium, Vibrio
cholerae, from stool or vomit, or by finding evidence
in the blood of the recent production of antibodies against
cholera.
What
is the treatment for cholera?
Cholera
can be treated by immediate replacement of the fluid and
salts lost through diarrhea. Patients can often be treated
with oral rehydration solution, but severe cases also require
intravenous fluid replacement. With prompt rehydration,
fewer than 1% of cholera patients will die. Antibiotics
shorten the course and diminish the severity of the illness,
but they are not as important as rehydration.
How
can cholera be prevented?
The
risk of cholera in the United States is virtually nonexistent,
and the risk for cholera is very low for travelers visiting
even those areas with epidemic cholera when simple precautions
are observed.
If
traveling to an area where cholera has occurred, the following
precautions are recommended:
- If
you drink water, buy it bottled or bring it to a rolling
boil for one minute before you drink it. Bottled carbonated
water is safer than uncarbonated water. Other safe beverages
include tea and coffee made with boiled water and carbonated,
bottled beverages with no ice.
- Ask
for drinks without ice unless the ice is made from bottled
or boiled water. Avoid popsicles and flavored ices that
may have been made with contaminated water.
- Eat
only foods that have been thoroughly cooked and are
still hot, or fruit that you have peeled yourself.
- Avoid
undercooked or raw fish or shellfish, including ceviche.
- Make
sure all vegetables are cooked; avoid salads.
- Avoid
foods and beverages from street vendors.
- Do
not bring perishable seafood back to the United States.
A
simple rule of thumb is: "Boil it, cook it, peel it,
or forget it!"
A
vaccine is available; however, it confers only brief and
incomplete immunity and is not recommended for travelers.
Where
can I get more information?
- Your
personal doctor.
- Your
local health department listed in your telephone directory.
- The
Utah Department of Health, Office of Epidemiology (801)
538-6191 or Immunization Program (801) 538-9450.
- The
Division of Quarantine, National Center for Infectious
Diseases, Centers for Disease Control and Prevention
has information on cholera and other diseases of concern
to travelers at http://www.cdc.gov/travel/travel.htm
UTAH DEPARTMENT OF HEALTH
OFFICE OF EPIDEMIOLOGY
July 2003
This
fact sheet was based on the Centers for Disease Control
and Prevention's Cholera Prevention guide (June 20, 2001).
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